Fellow Eye Comparison of Nerve Fiber Regeneration After SMILE and Femtosecond Laser-assisted LASIK: A Confocal Microscopy Study

• Published in: Journal of refractive surgery (1995) Vol. 31; no. 9; pp. 594 - 598
• Main Authors: Agca, Alper, Cankaya, Kadir I, Yilmaz, Ihsan, Yildirim, Yusuf, Yasa, Dilek, Olcucu, Onur, Demircan, Ali, Demirok, Ahmet, Yilmaz, Omer F
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01.09.2015
• Subjects: Adult; Astigmatism; Cornea; Cornea - innervation; Corneal Pachymetry; Corneal Stroma - surgery; Corneal Surgery, Laser; Female; Hospitals; Humans; Keratomileusis, Laser In Situ; Lasers; Lasers, Excimer - therapeutic use; Male; Microscopy; Microscopy, Confocal; Middle Aged; Myopia - surgery; Nerve Fibers - physiology; Nerve Regeneration - physiology; Patients; Postoperative Period; Retrospective Studies; Surgical Flaps; Topography; Trigeminal Nerve - physiology; Visual Acuity - physiology; Young Adult; Istanbul Turkey; Italy; Turkey; Germany
• ISSN: 1081-597X; 1938-2391
• DOI: 10.3928/1081597X-20150820-04

PURPOSE: To compare postoperative corneal nerve fiber regeneration after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK). METHODS: The medical records of patients who underwent SMILE were retrospectively reviewed. Patients with SMILE in one eye (the SMILE group) and FS-LASIK in the fellow eye (the FS-LASIK group) and who had undergone a confocal microscopy study were retrospectively identified. Subbasal nerve fiber density was measured and compared between the groups preoperatively and at 1 week and 1, 3, and 6 months postoperatively. RESULTS: Thirty eyes of 15 patients were included in the study. Preoperative characteristics of the eyes were similar between the groups. However, there was a statistically significant difference in subbasal nerve fiber density between the groups at 1 month (SMILE group: 1,505 ± 627 Thirty eyes of 15 patients were included in the study. Preoperative characteristics of the eyes were similar between the groups. However, there was a statistically significant difference in subbasal nerve fiber density between the groups at 1 month (SMILE group: 1,505 ± 627 µ m/mm 2 [range: 625 to 2,540 µ m/mm 2 ], FS-LASIK group: 1,107 ± 509 µ m/mm 2 [range: 595 to 2,313 µ m/mm 2 ], P = .003) and 3 months (SMILE group: 1,534 ± 503 µ m/mm 2 [range: 650 to 2,255 µ m/mm 2 ], FS-LASIK group: 1,194 ± 485 µ m/mm 2 [range: 530 to 1,695 µ m/mm 2 ], P = .004) postoperatively. No statistically significant difference was detected at 1 week and 6 months postoperatively. CONCLUSION: Eyes treated with SMILE have a higher density of subbasal nerve fibers than eyes treated with FS-LASIK in the early postoperative period (1 week to 3 months) but the two procedures are equivalent by 6 months postoperatively. [[ J Refract Surg. 2015;31(9):594–598.]